Laparoscopic adjustable gastric bands (AGB) are converted at high rates to secondary bariatric procedures. The available literature on the safety of converting in one- versus two-stage process has not included large databases.
To evaluate the safety of a one- versus two-stage conversion of AGB.
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), United States.
The MBSAQIP database for the years 2020 and 2021 were evaluated. One-stage AGB conversions were identified using Current Procedural Terminology codes and database variables. Multivariable analysis was performed to determine if one- or two-stage conversions were associated with 30-day serious complications.
There were 12,085 patients who underwent conversion from previous AGB to SG (63.0%) or RYGB (37.0%), of which 41.0% underwent conversion in one-stage and 59.0% in two-stages. Patients who underwent two-stage conversions had higher BMIs. Rates of serious complications were higher for patients undergoing RYGB compared to SG (5.2 vs 3.3%, p < 0.001), however, were similar between one-stage and two-stage conversions in both cohorts. In both cohorts, there were similar rates of anastomotic leaks, postoperative bleeding, reoperation, and readmissions. Mortality was rare and similar between conversion groups.
There was no difference in outcomes or complications in 30-days between one- and two-stage conversions of AGB to RYGB or SG. Conversions to RYGB have higher complication and mortality rates than to SG, but there was no statistically significant difference between staged procedures. Either one- or two-stage conversions from AGB are equivalent in safety.
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Accepted: February 24, 2023
Received in revised form: February 8, 2023
Received: October 31, 2022
Publication stageIn Press Journal Pre-Proof
Source of funding: None
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.